OBJECTIVE: The purpose of this study was to determine whether the slower- and longer-acting nifedipine tablets were as effective and safe as the rapid onset and short-acting nifedipine capsules for the treatment of acute severe hypertension in pregnancy. STUDY DESIGN:Sixty-four women in the second half of pregnancy who were not in labor randomly received 10 mg nifedipine tablets (n = 55 studies) or 10 mg nifedipine capsules (n = 74 studies) if blood pressure was > or =170/110 mm Hg. Blood pressure, heart rate, and cardiotocography were monitored over the subsequent 90 minutes. Successful treatment was a target blood pressure of 110 to 169/80 to 109 mm Hg after 90 minutes; unsuccessful treatment included fetal distress at any stage, the requirement for additional treatment (intravenous hydralazine), or the development of hypotension by 90 minutes after treatment. RESULTS:Nifedipine capsules lowered blood pressure further (28/19 vs 21/13 mm Hg; P =.03) than nifedipine tablets, but more than three quarters of each group had a successful treatment. Twice as many women (28%) who received nifedipine tablets required a second dose to achieve successful treatment (P =.05), but fewer women had hypotensive episodes (P =.001). Fetal distress was uncommon in both groups (3%-4%), and both groups were delivered an average of 4 days after the study. CONCLUSION:Nifedipine tablets, although of slower onset, are as effective as nifedipine capsules for the rapid treatment of severe hypertension in pregnancy.
RCT Entities:
OBJECTIVE: The purpose of this study was to determine whether the slower- and longer-acting nifedipine tablets were as effective and safe as the rapid onset and short-acting nifedipine capsules for the treatment of acute severe hypertension in pregnancy. STUDY DESIGN: Sixty-four women in the second half of pregnancy who were not in labor randomly received 10 mg nifedipine tablets (n = 55 studies) or 10 mg nifedipine capsules (n = 74 studies) if blood pressure was > or =170/110 mm Hg. Blood pressure, heart rate, and cardiotocography were monitored over the subsequent 90 minutes. Successful treatment was a target blood pressure of 110 to 169/80 to 109 mm Hg after 90 minutes; unsuccessful treatment included fetal distress at any stage, the requirement for additional treatment (intravenous hydralazine), or the development of hypotension by 90 minutes after treatment. RESULTS:Nifedipine capsules lowered blood pressure further (28/19 vs 21/13 mm Hg; P =.03) than nifedipine tablets, but more than three quarters of each group had a successful treatment. Twice as many women (28%) who received nifedipine tablets required a second dose to achieve successful treatment (P =.05), but fewer women had hypotensive episodes (P =.001). Fetal distress was uncommon in both groups (3%-4%), and both groups were delivered an average of 4 days after the study. CONCLUSION:Nifedipine tablets, although of slower onset, are as effective as nifedipine capsules for the rapid treatment of severe hypertension in pregnancy.
Authors: Laura A Magee; Edgardo Abalos; Peter von Dadelszen; Baha Sibai; Tom Easterling; Steve Walkinshaw Journal: Br J Clin Pharmacol Date: 2011-09 Impact factor: 4.335
Authors: Laura A Magee; Edgardo Abalos; Peter von Dadelszen; Baha Sibai; Stephen A Walkinshaw Journal: Curr Hypertens Rep Date: 2009-12 Impact factor: 5.369
Authors: Catherine A Fitton; Markus F C Steiner; Lorna Aucott; Jill P Pell; Daniel F Mackay; Michael Fleming; James S McLay Journal: J Hypertens Date: 2017-11 Impact factor: 4.844